High rates of early HBeAg seroconversion and relapse in Indian patients of chronic hepatitis B treated with Lamivudine: results of an open labeled trial.
High rates of early HBeAg seroconversion and relapse in Indian patients of chronic hepatitis B treated with Lamivudine: results of an open labeled trial.
复制标题
印度慢性乙型肝炎患者接受拉米夫丁治疗的印度患者的早期HBEAG血清转化和复发率很高：开放标记试验的结果。
DOI：
10.1186/1471-230x-5-29
复制
发表时间：
2005-09-15
影响因子：
2.4
通讯作者：
Choudhuri, G
中科院分区：
文献类型：
--
作者：
Alexander, G;Baba, CS;Chetri, K;Negi, TS;Choudhuri, G
拉米夫定在慢性乙型肝炎（CHB）中的应用是众所周知的，然而报道的HBeAg血清转化率及其治疗后的持久性存在很大差异。我们进行了本研究，研究拉米夫定对印度慢性乙型肝炎患者HBeAg丢失和血清转化率的影响，涉及频率、预测因素和持久性。我们用拉米夫定治疗了60例e抗原阳性CHB患者（病毒复制活跃和持续的坏死炎症活动）。随访每月转氨酶、3个月HBeAg和抗hbe。达到HBeAg血清转化的患者建议在6个月后停用拉米夫定，此后每3个月随访一次，观察复发情况。如果没有血清转化，治疗时间最长为3年。拉米夫定患者HBeAg的年增量损失在第一年末为25(41.6%)，在第二年末为33(55%)，在第三年末为35（58.3%）。3年内相应的血清完全转化率分别为17/60（28.6%）、22/60（36.6%）和24/60（40%）。HBeAg损失与治疗前ALT水平升高（p = 0.002）和治疗前HBV-DNA水平降低（p = 0.004）相关。肝硬化的存在对HBeAg损失率没有影响。治疗后中位时间6个月复发率为35%（7/20）。印度患者在拉米夫定治疗的第一年表现出较高的HBeAg血清转换率。这与基线ALT相关，与HBV-DNA水平呈负相关。治疗后复发率高，停药后不久复发率高。
The use of Lamivudine in chronic hepatitis B (CHB) is well known, however the reported rate of HBeAg sero-conversion and its durability post-treatment have varied considerably. We undertook the present study to study the effect of Lamivudine on HBeAg loss and seroconversion rates in Indian patients of CHB in relation to frequency, predictors and durability. We treated 60 patients of e antigen positive CHB (with active viral replication and ongoing necro-inflammatory activity) with Lamivudine. They were followed up by monthly aminotransferases, and 3 monthly HBeAg and anti-HBe. Those who attained HBeAg sero-conversion were advised to discontinue Lamivudine after 6 months and followed up every 3 months thereafter, to see for relapse. Treatment was given for maximum of 3 years if not sero-converted. The annual incremental loss of HBeAg in patients receiving Lamivudine was 25 (41.6%) at end of 1st year, 33 (55%) at 2nd year and 35 (58.3%) at 3rd year. The corresponding rates for full sero-conversion were 17/60 (28.6%), 22/60 (36.6%) and 24/60 (40%) in the 3 years. HBeAg loss correlated with increased pre-therapy ALT levels (p = 0.002) and decreased pretreatment HBV-DNA levels (p = 0.004). The presence of cirrhosis had no influence on the rate of HBeAg loss. Relapse occurred in 35% (7/20) post-treatment at median time of 6 months. Indian patients showed a higher rate of HBeAg sero-conversion in the first year of Lamivudine treatment. This correlated with baseline ALT and inversely with HBV-DNA levels. Relapse rate after treatment was high and occurred soon after stopping treatment.